EVALUATION OF UMBILICAL ARTERY DOPPLER INDICES IN THIRD TRIMESTER MATERNAL ANEMIA AND ASSOCIATION WITH FETAL GROWTH RESTRICTION

Abstract

Background: Maternal anemia is a common pregnancy complication that affects placental oxygen delivery and can disrupted fetoplacental circulation thereby exposing the fetus to the risk of fetal growth restriction. The Umbilical artery Doppler assessment is used to detect a change in the placental resistance during the third trimester because at that time the fetus is at its maximum oxygen demand. The correlation between the severity of anemia and changes observed in Doppler is significant in order to enhance fetal monitoring and determine the way interventions can be given in time.

Objective: To assess umbilical artery Doppler indices (PI, RI, S/D ratio) and EDF in third trimester anemic pregnancy and determine their correlation with fetal growth restriction.

Methods: Descriptive cross-sectional study was done to 111 anemic third-trimester pregnant women with non-probability purposive sampling technique. Maternal demographics, level of anemia, umbilical artery Doppler parameters, and fetal biometry were taken and anonymized according to proper ethical standards. The statistical analysis was conducted with SPSS 26.

Results: The participants had 31.5% mild, 66.7% moderate, and 1.8% severe cases of anemia. The severity of anemia was positively correlated with Doppler indices. Mild anemia recorded nearly normal mean values (PI 0.917, RI 0.568, S/D ratio 2.287), moderate anemia recorded slightly high mean values (PI 0.918, RI 0.59, S/D ratio 2.572), whereas severe anemia recorded high mean values (PI 1.440, RI 0.790, S/D ratio 4.740). In all the cases, end-diastolic flow was maintained. Severe anemia was related with high Doppler indices and fetal growth restriction.

Conclusion: Doppler indices increase with the severity of anemia, indicating that there is an increase in placental resistance. Extreme anemia is the primary manifestation in fetal growth restriction. Umbilical artery Doppler measurement is an effective screening method that may be applicable in the detection of at-risk pregnancy to utilize the method to conduct monitoring and take measures that could lead to a better outcome.